First Responder Assistance in Managing Major Incidents: Assessing the Potential of Smartphone Alerting Systems to Provide Support–Findings from a Model Region in Germany

Introduction: The activation of volunteer first responders (VFR) near out-of-hospital cardiac arrests is recommended by current guidelines. Advanced smartphone alerting systems (SAS) alert registered medical professionals who are able to arrive at the scene before emergency services. In addition, these systems could potentially inform, dispatch, and enable VFR to provide quick, accurate reports during major incidents or disasters. This study evaluates the potential of using SAS for major incidents by retrospectively examining performance criteria of the “Region of Lifesavers” system. Methods: In this retrospective study, the “Region of Lifesavers” system was analyzed in August 2024 in the Freiburg region (1,531 km², 493,036 population). The analysis focused on the number, profession, and availability (acceptance, distance) of VFR. Descriptive analysis of the system’s operation data was conducted using Microsoft Excel Business (v2408). The study was approved by the Ethics Committee Freiburg (No: 23-1450-S1). Results: A total of 1,657 VFR were registered in the system, equipped with basic medical equipment. Their affiliations were: EMS (663), hospital staff (381), medical students (114), firefighters (103), police with medical qualification (90), mountain rescue (57), physicians (53), admins (13), and others/unknown (183). Of the 127 alerts, 89 (70%) were accepted by at least one VFR. On average, 20 VFR were in the pre-alert area within five kilometers of the scene. The median airline distance from VFR to the scene was 628 m (IQR 1042 m, N = 156). Conclusion: The study demonstrates adequate availability and geographical coverage of VFR with professional qualifications. The high alert acceptance rate indicates a strong willingness to participate in operations. With further technological advancements, the system could play a promising role in supporting the management of major incidents in the future. Appropriate app features should be designed and developed to facilitate subsequent practical testing.